SEATTLE POST-INTELLIGENCER STAFF AND NEWS SERVICES

Published 10:00 pm, Sunday, December 8, 2002

A treatment used by thousands of people with epilepsy may offer hope for those suffering from severe depression, Alzheimer's disease and chronic migraines.

Results of 35 studies of vagus nerve stimulation therapy are being presented at the American Epilepsy Society's annual meeting, which began Friday in Seattle.

The meeting gives more than 2,000 academics and medical professionals the chance to share the latest research on a disorder that affects 3 million Americans and costs $12.5 billion annually in medical care.

Like a cardiac pacemaker, vagus nerve stimulation therapy involves surgeons implanting a small generator in a patient's chest.

The device is wired to the vagus nervein the neck.

Automatically stimulating that nerve for 30 seconds, every five minutes, 24 hours a day, can greatly reduce epileptic seizures.

The regular pulses interrupt elec- trical bursts in the brain, which cause seizures.

The treatment doesn't cure epilepsy, doctors said, but it can greatly reduce the number and severity of seizures and decrease the reliance on drugs, which typically have unpleasant side effects.

That was true for a 5-year-old Spokane child, Kevin Tsuchida, who started having seizures when he was 3 1/2 .

Kevin sometimes had hundreds of seizures a day and was forced to stay on a couch to play for his own safety.

He had to be strapped into a car seat while eating dinner to avoid lurching forward.

The seizures were severe enough to send him crashing to the ground and to cause broken teeth, split lips, black eyes and bloody noses, said his mother, Missy Tsuchida. "It's like someone invisible pushes him to the ground."

Doctors tried nearly a dozen medications over two years to try to control the seizures, at one point giving him 16 different pills a day, but the side effects just made him worse.

Kevin got the implant in July and is now down to one medication. He has since gone more than 100 days without a seizure.

Since the vagus nerve runs by the vocal cords, the stimulation can change people's voices. For Missy Tsuchida's son, "it sounds like a cat purring when Kevin talks."

Karen Becker, a 47-year-old casino employee in Laughlin, Nev., had the operation done in May. "It has given me a better quality of life that I never thought I could have," said Becker, who has had epilepsy since she was 7.

Even though she still gets some seizures, the implant's electrical signals make them less severe and shorter, allowing her to recover more quickly. "It has allowed me to participate in life," she said.

Other research at the six-day conference include advances in brain mapping, brain surgery and the genetics of epilepsy, said Dr. Angus Wilfong, medical director of the Comprehensive Epilepsy Program at Texas Children's Hospital and assistant professor of pediatrics and neurology at Baylor College of Medicine in Houston.

The Food and Drug Administration approved vagus nerve stimulation therapy five years ago. More than 18,000 implants have been done worldwide.

The therapy can help the approximately 40 percent of epileptics who get little relief from medications, Wilfong said. Other options include brain surgery and a rigid, unpalatable diet.

Some preliminary studies have suggested the therapy can help with other conditions.

Last year, the therapy was approved as a treatment for depression in European Union countries, "despite the limited evidence" it helps, according to the Harvard Mental Health Letter, a newsletter published by the Harvard Medical School.

In a study published last month, the therapy improved cognition in 10 Alzheimer's patients in Sweden.

People with epilepsy can experience more than 30 types of seizures, many of which can go unnoticed by others.

Even people who experience them may not realize they have epilepsy. Some simple partial seizures can cause people to see lights, hear a buzz, feel tingling or numbness, even sense strange tastes or smells.

It is also a disorder that many don't understand.

"Ooh, there's a big stigma. People know more about breast cancer than they do about epilepsy," Missy Tsuchida said.